Annals of hepatology最新文献

{"title":"Skeletal muscle as a source of IGFBP-2 in a murine model of metabolic dysfunction associated with steatotic liver disease.","authors":"Miriam G. Bautista-Ubaldo ,&nbsp;Bryan M. Ata-Calixto ,&nbsp;Diana Paola Osnaya-Burgos ,&nbsp;Ignacio González-Sánchez ,&nbsp;Gabriela Gutiérrez-Reyes ,&nbsp;Carolina Guzmán","doi":"10.1016/j.aohep.2025.101822","DOIUrl":"10.1016/j.aohep.2025.101822","url":null,"abstract":"<div><h3>Introduction and Objectives</h3><div>Insulin-like Growth Factor Binding Protein (IGFBP)-2 is lower in serum during obesity and metabolic dysfunction. We have previously shown that the decrease in serum IGFBP-2 follows a diminished expression in liver and heart, both associated with the progression of steatotic liver disease. We aimed to identify, in a murine model, the synthesis of IGFBP-2 in extrahepatic tissues involved in metabolic dysfunction: skeletal muscle and adipose tissue.</div></div><div><h3>Materials and Patients</h3><div>Samples of hamstring muscle, and epididymal adipose tissue were obtained from male C57BL/6 mice, fed a high-fat diet supplemented with sucrose and fructose (42g/L) in the beverage during 6 months. All procedures were approved by the Institutional Committee of Care and Use of Laboratory Animals at the School of Medicine, UNAM (FM/DI/005/2022). Four groups were included: Control; Metabolic dysfunction (MD), exhibiting increased bodyweight and adiposity; MD with steatosis (MD+SS); and MD+SS with fibrosis (MD+SS+F). Total protein was isolated in a protease inhibitor cocktail. Protein integrity was assessed by SDS-PAGE. IGFBP-2 was assayed by ELISA. Data was shown as Mean±SD, analyzed by one-way ANOVA; Student´s t test was applied to compare 2 groups. P&lt;0.05 was considered significant.</div></div><div><h3>Results</h3><div>IGFBP-2 expression was 6-fold increased in control skeletal muscle compared to control adipose tissue. In epididymal adipose tissue, IGFBP-2 expression significantly decreased in MD+SS+F compared to Controls, and MD. In contrast, the hamstring showed increased IGFBP-2 expression in mice showing metabolic dysfunction associated with steatotic liver disease: MD+SS and MD+SS+F. The percentage of adiposity significantly increased in MD subjects whereas no changes were observed regarding muscle mass, suggesting hypertrophy might be key.</div></div><div><h3>Conclusions</h3><div>Our results show that metabolic dysfunction (MD) associated with MASLD have a role in inhibiting IGFBP-2 expression in adipose tissue. In contrast, skeletal muscle increases its synthesis. These results suggest a role for skeletal muscle in the reversion of MASLD through IGFBP-2 expression. More studies are needed to identify the roles of skeletal muscle and its hypertrophic state in MASLD.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"30 ","pages":"Article 101822"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143895845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of MELD Scores as Predictors of Mortality in Patients with Decompensated Chronic Liver Disease with Variceal Hemorrhage at a third-level care center.","authors":"Laura V. Cupil-Escobedo,&nbsp;Karina Cazarin-Chavez,&nbsp;María F. Higuera-De La Tijera","doi":"10.1016/j.aohep.2025.101873","DOIUrl":"10.1016/j.aohep.2025.101873","url":null,"abstract":"<div><h3>Introduction and Objectives</h3><div>The variceal hemorrhage is the most common cause of decompensation in patients with chronic liver disease. Hemoglobin level has been used to classify severity; however, it is unreliable. This study aims to evaluate MELD scores as predictors of mortality in patients with variceal hemorrhage.</div></div><div><h3>Materials and Patients</h3><div>An observational, retrospective, comparative, and longitudinal study was conducted on patients hospitalized in the Gastroenterology department for one year, who were admitted with a diagnosis of variceal hemorrhage and met the criteria for applying the MELD score within the first 48 hours of hospitalization. Descriptive and inferential statistics were performed using ROC curves. Demographic variables, MELD, MELD Na, and MELD Lactate scores were evaluated. The initial and follow-up hemoglobin levels were assessed. Additionally, hospitalization days and discharge reasons were considered.</div></div><div><h3>Results</h3><div>A total of 96 patients were analyzed (60 women and 36 men) with an average age of 62 ± 8 years. Regarding the etiology of cirrhosis, Alcohol: 48, MASLD: 18, METALD: 8, Viral: 4, Unspecified: 6, Autoimmune: 16. In the analysis of ROC curves, it was found that there was a significant mortality prediction for the MELD, MELD Na, and MELD Lactate models. The MELD cutoff of 21.5 points presented an AUROC of 0.866 (95% CI: 0.71-1.00, p= &lt;0.001), MELD Na of 20.5 had an AUROC of 0.848 (95% CI: 0.67-1.00, p= &lt;0.001), and the MELD Lactate cutoff of 20.5 had an AUROC of 0.791 (95% CI: 0.644-0.939, p= 0.003)</div></div><div><h3>Conclusions</h3><div>In the analysis of ROC curves, the MELD, MELD Na, and MELD Lactate models demonstrated a significant predictive capacity for mortality. The AUROC values were 0.866, 0.848, and 0.791 respectively, confirming their utility in clinical practice for patients with chronic liver disease admitted in the context of decompensation due to variceal bleeding.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"30 ","pages":"Article 101873"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143895862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characteristics of overlap syndrome in Mexican patients.","authors":"Claudia G. Solis-Hernandez,&nbsp;Marycamen Alegria-Ovando,&nbsp;Kenia M. Bastida-Guadarrama,&nbsp;Viridiana Lopez-Ladron-de-Guevara,&nbsp;Maria F. Higuera-de-la-Tijera,&nbsp;Jose L. Perez-Hernandez","doi":"10.1016/j.aohep.2025.101874","DOIUrl":"10.1016/j.aohep.2025.101874","url":null,"abstract":"<div><h3>Introduction and Objectives</h3><div>The overlap syndrome combines two or more autoimmune liver diseases such as: autoimmune hepatitis, primary biliary cholangitis and primary sclerosing cholangitis, in Mexico there is little information about this disease. Objective: To describe the characteristics of the Mexican population with overlap syndrome treated at the liver clinic of the General Hospital of Mexico.</div></div><div><h3>Materials and Patients</h3><div>This is a retrospective, observational and analytical study in which records of patients with ADHD who met overlapping criteria (two or more hepatic autoimmune diseases) between 2020 and 2024 were reviewed to evaluate demographic variables and their presentation. Descriptive statistics with measures of central tendency and dispersion were used using SPSS 25.0. Liver enzymes AST, ALT, GGT, in addition to BT and FA of EHAI, CBP and CEP compared to CEP+EHAI were compared with Student's t-test for independent groups. Values are expressed as means and standard deviations. The Z test for contingency tables for difference of proportions with Bonferroni correction was used to compare the percentages of the degree of fibrosis among the four groups (EHAI, CBP, CEP and CEP+EHAI). A significance level of less than 5% was considered in all tests.</div></div><div><h3>Results</h3><div>A total of 256 patients with AHD were evaluated, of whom 55 (21.4%) were found to be compliant for overlap syndrome. Of these, 93.6% were female and 7.3% male, with a mean age of 51.89 ± 12.72 years (range: 50.34-53.44). The most common phenotype was CBP/HAI (73.2%). The most frequent autoimmune comorbidities were hypothyroidism, rheumatoid arthritis, Sjögren's syndrome and systemic sclerosis. 32.1% had grade F3 fibrosis and 16.3% cirrhosis, Child A 12.5%, Child B 62.5% and Child C 25%. A higher proportion of fibrosis was observed in F2 and F3 for overlap syndrome compared to EHAI. Regarding enzymatic tests, significant differences were found in GGT (183.5±254.5 vs. 318.5±232.8) and AF between EHAI and overlap syndrome. The most frequent decompensation was variceal gastrointestinal bleeding in 62.5%, and three patients were transplanted.</div></div><div><h3>Conclusions</h3><div>Overlap syndrome is an uncommon entity, frequent in women, which is usually associated with other autoimmune pathologies. It is associated with more severe results in liver biochemical tests, especially in GGT and AF levels, as well as with a higher degree of fibrosis.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"30 ","pages":"Article 101874"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143895863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical manifestations, and oxidative stress imbalance in children with obesity and MASLD","authors":"Isabel Villagómez-López ,&nbsp;Laura Mejía-Pérez ,&nbsp;Moisés Martínez-Castillo ,&nbsp;Liliana Suárez-Bonilla ,&nbsp;Daniel Santana-Vargas ,&nbsp;Zaira Medina-Avila ,&nbsp;Abigail Hernandez-Barragan ,&nbsp;Jessica Limon-Castillo ,&nbsp;Dana Mercado-Herrera ,&nbsp;Gabriela Gutierrez-Reyes","doi":"10.1016/j.aohep.2025.101884","DOIUrl":"10.1016/j.aohep.2025.101884","url":null,"abstract":"<div><h3>Introduction and Objectives</h3><div>Metabolic dysfunction-associated steatotic liver disease (MASLD) is often considered a multifactorial disease that has shown high incidence in recent years in both children and adults. To date, management criteria, diagnosis, and clinical characteristics are not fully defined in childhood.</div></div><div><h3>Objective</h3><div>Evaluate anthropometric characteristics, biochemical data, clinical manifestations, and Redox balance status in pediatric patients with obesity.</div></div><div><h3>Materials and Patients</h3><div>A cross-sectional study that included 300 pediatric patients (aged 8 to 17 years) from the obesity clinic of Iztapalapa Pediatric Hospital. Subjects were classified as with MASLD or without MASLD using hepatic ultrasonography. A thorough evaluation of anthropometric characteristics, clinical features, and blood levels of reduced glutathione (GSH) and oxidized glutathione (GSSG) was conducted. Data were reported as absolute and relative frequencies (%), while continuous variables were determined as mean ± SD and analyzed using Student's t-test and Mann-Whitney U test via SPSS V.22 software.</div></div><div><h3>Results</h3><div>A total of 95 patients met the inclusion criteria, with 78 cases having MASLD and 17 without MASLD: 27% were aged 8-9 years and 73% were adolescents (10-17 years). Being children receiving care for obesity, anthropometric data (weight, BMI (WHO, CDC), waist/height ratio, waist/hip ratio, and % body fat) showed no significant differences between groups. Greater respiratory difficulty (p=0.037) and polyuria (p=0.047) were observed in patients with MASLD vs. those without MASLD. Additionally, AST, urea, and creatinine levels were elevated in MASLD (p&lt;0.05). Finally, GSH was reduced in MASLD vs. non-MASLD (p=0.001), thus altering the GSH/GSSG ratio.</div></div><div><h3>Conclusions</h3><div>Reduced glutathione indicates increased oxidation in children with MASLD, showing a clear association with liver damage even in the early stages of the disease. The incorporation of new tools in the diagnosis and management of obese children is a primary need to reduce the high prevalence and thus improve quality of life and life expectancy.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"30 ","pages":"Article 101884"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143895787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute-on-chronic liver failure due to hepatitis A infection in a patient with Metabolic Dysfunction- Associated Fatty Liver Disease. Case report.","authors":"Omar Ocampo-Espinosa,&nbsp;Mariana Jacinto-Ruiz","doi":"10.1016/j.aohep.2025.101841","DOIUrl":"10.1016/j.aohep.2025.101841","url":null,"abstract":"<div><h3>Introduction and Objectives</h3><div>Metabolic Dysfunction-Associated Fatty Liver Disease (MAFLD) has steadily increased its prevalence, making it the most common liver disease in Western industrialized nations, affecting one billion people worldwide. Hepatitis A is a necro-inflammatory liver disease caused by the hepatitis A virus (HAV). Less than 1% develop acute liver failure, where 30% will require a liver transplant and 70% will require supportive therapy until recovery. Hepatic steatosis is recognized as a risk factor for developing the severe variant of HAV disease. We present this case of acute liver failure due to HAV in a patient with MAFLD.</div></div><div><h3>Materials and Patients</h3><div>37-year-old male with a history of systemic arterial hypertension and morbid obesity. He presented headache, fever, asthenia, adynamia, choluria and acholia with a positive viral profile for hepatitis A virus (IgM +, IgG +). Two days later, with an attack on general condition, in addition to neurological deficit with gradual deterioration of alertness. Simple computed axial tomography of the skull without alterations. Hepatosplenic Doppler ultrasound: Chronic diffuse liver disease, Doppler criteria for grade I venous restrictive liver disease, splenomegaly. He presented multiple organ failure due to coagulopathy, acute liver failure and kidney injury and was sent to a third-level unit for Molecular Adsorbent Recirculating System (MARS) therapy.</div></div><div><h3>Results</h3><div>It was classified as grade 3B acute-on-chronic liver failure without being a candidate for transplant. During his hospitalization, MARS therapy was performed on two occasions: single-session hemodialysis, hypertonic solution for cerebral edema, and treatment for hyperammonemia. He was started on carvedilol, vitamin E and lipophilic statin. Without organ failure, creatinine levels normalized, mild transaminasemia persisted and as well as hyperbilirubinemia at the expense of direct bilirubin. Continuing follow-up by external consultation.</div></div><div><h3>Conclusions</h3><div>The complex interaction between hepatic steatosis, hepatitis A infection and acute-on-chronic liver failure is highlighted, noting the importance of comprehensive evaluation and multidisciplinary management. The increasing prevalence of hepatic steatosis poses additional challenges in the management of hepatitis A, increasing the risk of severe forms of the disease. Timely and specialized treatment are essential to address this complex clinical condition.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"30 ","pages":"Article 101841"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143896106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adverse effects of the use of terlipressin infusion compared to boluses in patients with liver cirrhosis and variceal hemorrhage. TERMEX study.","authors":"Luis R. Antuna-Villaseñor,&nbsp;Germán A. Roman-Lugo,&nbsp;Jose Pérez-Sánchez,&nbsp;Alexis E. Chavarín-Meza,&nbsp;Yvonne Tadeo-Jiménez,&nbsp;Rosalba Moreno-Alcántar,&nbsp;Aleida Bautista-Santos","doi":"10.1016/j.aohep.2025.101833","DOIUrl":"10.1016/j.aohep.2025.101833","url":null,"abstract":"<div><h3>Introduction and Objectives</h3><div>Cirrhosis is a worldwide health problem as it is a leading cause of mortality. The development of complications in cirrhosis is directly related to the presence of portal hypertension. The risk of annual variceal hemorrhage is 5% for small varices and 15% for large varices. Terlipressin represents a useful drug for this group of patients; classically it has been used in bolus but recent studies have shown that its use in infusion may be superior in bleeding control and with fewer adverse effects. The aim of this study is to define whether there are fewer adverse effects with the use of terlipressin infusion compared to bolus.</div></div><div><h3>Materials and Patients</h3><div>We include patients in the care of the gastroenterology department from July to December 2023 who met the inclusion criteria were included: &gt;18 years, diagnosed with liver cirrhosis and variceal hemorrhage, who had received terlipressin infusion or bolus. Statistical analysis: descriptive statistics, frequencies and percentages were calculated with Student's t and Mann-Whitney U according to the distribution of the variables; Student's t was used to show differences between groups and chi-square to determine the risk of adverse events with bolus respect terlipressin infusion. Wilcoxon test was applied to show differences between groups.</div></div><div><h3>Results</h3><div>58 patients were included, all received endoscopic treatment in addition to terlipressin: 16 patients received infusion (27.6%) and 42 (77.4%) received terlipressin in bolus. Female gender predominated with 30 (51.7%), mean age was 55.8 ±10.93 years; the most frequent etiologies of liver cirrhosis were: (MASLD) steatotic liver disease associated with metabolic dysfunction 19 (32.8%), primary biliary cholangitis 12 (20.7%) and MASLD with significant alcohol consume (MetALD) 8 (13.8%). The median MELD was 16 (12-20) points, and the median Child-Pugh Turcotte score was 7 (6-9). Rebleeding occurred in 8 (13.8%) patients and one patient required rescue TIPS (transjugular portosystemic shunt). The percentage of adverse effects was 27.6% (n=16) and therapy was changed to octreotide in 15 (25.9%) patients. The bolus group had 31% (n=13) adverse effects compared to the infusion group where only 3 (18%). The main adverse effect was abdominal pain in 15.5% (n=9). Mortality was 6.9% in our study(n=4).</div></div><div><h3>Conclusions</h3><div>Adverse effects of terlipressin infusion compared to bolus had no significant difference in the group analyzed. However, there is a tendency in favor of infusion since only 3 patients had adverse effects, we consider that by increasing the sample size, there could be difference in favor of the infusion group.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"30 ","pages":"Article 101833"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143896146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of the effect of HCV Core protein on the epithelial-mesenchymal transition (EMT) process in non-tumorigenic immortalized hepatocytes","authors":"Verónica Alvarado-Martínez,&nbsp;Tania G. Heredia-Torres,&nbsp;Sonia A. Lozano-Sepúlveda,&nbsp;Ana M. Rivas-Estilla","doi":"10.1016/j.aohep.2025.101808","DOIUrl":"10.1016/j.aohep.2025.101808","url":null,"abstract":"<div><h3>Introduction and Objectives</h3><div>The HCV Core protein is involved in metabolic remodeling and, energy reprogramming through enzymatic changes and redistribution of energy resources, promoting epithelial-mesenchymal transition (EMT) and liver disease. This study addressed the metabolic changes involved in EMT by evaluating the expression of Vimentin and E-cadherin in a non-cancerous cell model.</div></div><div><h3>Materials and Patients</h3><div>An expression plasmid for the HCV Core protein genotype 1b (p-Core) was designed. Transient transfection was performed in the THLE-2 cell line, characterized by a morphology similar to non-tumorigenic human hepatocytes and the expression of differentiated hepatocyte markers, making it ideal for metabolic assays due to its ability to express and regulate proteins involved in metabolism more effectively than primary hepatocyte cultures. For the transfection, p-Core concentrations of 0.5 - 2.0 µg were used, and the cells were cultured for 72 hours. Subsequently, total proteins were extracted and quantified using PKR buffer. The expression levels of Core, Vimentin, and E-cadherin proteins were evaluated by Western Blot, using 40 µg of protein. The relative expression of the proteins was calculated in relation to the endogenous expression of GAPDH using ImageJ software, and the analysis was performed in triplicate.</div></div><div><h3>Results</h3><div>The expression of the viral Core protein (21 kDa) was detected in THLE-2 cells transfected with the p-Core plasmid at 72 hours. It was observed that the expression of the E-cadherin protein (120 kDa) decreased by 80% (in cells transfected with 0.5 µg) and by 25% in cells transfected with 2.0 µg of p-Core. Lastly, an increase in the expression levels of the Vimentin protein (57 kDa) was observed in relation to the concentration of p-Core, doubling with 0.5 µg and increasing sixfold with 2.0 µg of p-Core.</div></div><div><h3>Conclusions</h3><div>The expression of the viral Core protein modulates the translational expression levels of E-cadherin and Vimentin in THLE-2 cells, suggesting its possible involvement in cell adhesion, mobility, and metabolism by HCV. However, detailed studies of the implicated metabolic pathways are required to establish the activation pathways involved.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"30 ","pages":"Article 101808"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143895998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Portal cholangiopathy secondary to cavernomatous transformation of the portal vein. Case report","authors":"Karla J. Arroyo García,&nbsp;Luis A. Esquivel-Pacheco,&nbsp;Alexis V. Hinostroza-Pezo,&nbsp;Adolfo Gamiño-Morfín,&nbsp;Alejandro D. Mendoza-Rea,&nbsp;Luis R. Alvarez-Martín,&nbsp;Carlos A. Galvan-Castro","doi":"10.1016/j.aohep.2025.101810","DOIUrl":"10.1016/j.aohep.2025.101810","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction and Objectives&lt;/h3&gt;&lt;div&gt;Portal cholangitis is a set of alterations that appear in the bile duct secondary to portal hypertension (PH). It is extremely rare and its main etiology is cavernomatous transformation of the portal vein (CPVT). The objective is to present the case of a patient with portal cholangiopathy secondary to TCVP.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Materials and Patients&lt;/h3&gt;&lt;div&gt;A 17-year-old man with no relevant history began with hemorrhoidal bleeding, requiring hemorrhoidectomy. After 3 weeks, he presented abdominal pain and constipation. Abdominal computed tomography revealed free abdominal fluid, splenomegaly, and portal dilation. A diagnostic paracentesis was performed with GASA 3.1 and liver Doppler ultrasound with a 9mm portal vein, collateral veins, thrombosis and portal cavernomatosis. Initial endoscopy showed small esophageal varices. Hepatotropic infections, HIV and thrombophilias were ruled out, concluding prehepatic PH secondary to TCVP and Child-Pugh A chronic liver disease (CLD).&lt;/div&gt;&lt;div&gt;At 3 years of follow-up, jaundice, generalized pruritus, direct hyperbilirubinemia asadded, with CA 19.9, normal IgG, negative ANA and AMA, and cholangio resonance with stenosis of the common bile duct and dilation of the intrahepatic and extrahepatic bile ducts.&lt;/div&gt;&lt;div&gt;In 2023, at 24 years of age, he had advanced decompensated CLD secondary to probable portal cholangiopathy due to TCVP, with persistent ascites, large esophageal varices, encephalopathy and recurrent cholangitis, so it was decided to place percutaneous drainage with biochemical improvement but presenting new episode of severe acute cholangitis associated with septic shock and acute-on-chronic liver failure, with a torpid evolution despite management with meropenem and ceftriaxone.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;TCVP is characterized by the formation of dilated collateral venous pathways in the portal vein, secondary to portal thrombosis, causing PH. A rare complication of both is portal cholangiopathy.&lt;/div&gt;&lt;div&gt;In the clinical case presented, what is notable is the patient's evolution characterized by cholestasis and CLD secondary to cavernomatosis due to portal thrombosis of unknown cause with progression of complications derived from portal hypertension. As part of the approach, hepatic infectious and hepatic autoimmune processes are ruled out and CA 19.9 is requested to assess the risk of cholangiocarcinoma. Subsequently, a magnetic resonance cholangiography was performed which showed a stenosis of the common bile duct.&lt;/div&gt;&lt;div&gt;Therefore, a portal cholangiopathy was considered due to the history of TCVP and the clinical, biochemical and imaging data that supported the diagnosis despite its low frequency. There are various theories about PH and its involvement of the bile duct, but it is considered to be due to compression of the bile duct walls secondary to the cavernoma, dilation of the venous plexuses of the common bile duct and ischemia,","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"30 ","pages":"Article 101810"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143896000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ceftriaxone versus cefotaxime in the treatment of spontaneous bacterial peritonitis","authors":"Carlos A. Campoverde-Espinoza,&nbsp;Daniel Santana-Vargas,&nbsp;Alejandro Tovar-Durán,&nbsp;Brenda Govea-Mendoza,&nbsp;Verónica G. Pérez-Pérez,&nbsp;Fátima Higuera-De la Tijera,&nbsp;José L. Pérez-Hernández","doi":"10.1016/j.aohep.2025.101863","DOIUrl":"10.1016/j.aohep.2025.101863","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction and Objectives&lt;/h3&gt;&lt;div&gt;Infections in cirrhotic patients occur in one-third of hospitalized patients. Spontaneous infections (spontaneous bacteremia, spontaneous bacterial peritonitis (SBP), and spontaneous empyema) are the most common and their management with third-generation cephalosporins (cefotaxime or ceftriaxone) is recommended. The effect of albumin on in vitro antimicrobial activity is greater for cefotaxime.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Materials and Patients&lt;/h3&gt;&lt;div&gt;This is a retrospective, observational, and analytical study. We included clinical records of patients admitted to the Gastroenterology service of the Hospital General de México “Dr. Eduardo Liceaga” from March 2021 to February 2024 with a diagnosis of SBP ≥ 250 polymorphonuclears (PMN), comparing two different treatments (cefotaxime 2gr c/12 hours vs ceftrixone 1 or 2gr/day) and follow-up one year after the event. We evaluated the response to treatment with a second paracentesis with 48 hours of antibiotic therapy. We determined the recurrence at 12 months and the relationship with serum albumin levels in treated patients. We excluded patients with secondary bacterial peritonitis, tuberculosis or carcinomatosis, and previous antibiotic use (except rifaximin). Qualitative variables were expressed as frequencies and percentages; numerical variables as means and standard deviation. We used X2, Student's t-test, and Mann-Whitney U to compare the variables. To compare the percentages of deaths per treatment, response rate, and recurrences at one year, we used the Z test for contingency tables. The log-rank test and the Kaplan-Meier survival curve were used to evaluate survival per treatment at 30 days. A value of &lt;em&gt;P&lt;/em&gt; &lt; 0.05 was considered statistically significant.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Out of 950 hospitalized cirrhotic, 6.42% (61) presented SBP. 63.9% were male and aged 52±11.9 years. Etiology of cirrhosis, 39.3% alcohol, 26.2% unfiliated, 14.8% MASLD, and 8.2% autoimmune hepatitis. Comparing groups, 29 patients with cefotaxime and 32 with ceftriaxone, with no differences concerning Child-Pugh, MELD score (23 vs 31, &lt;em&gt;p&lt;/em&gt;=0.07), acute on chronic liver failure (ACLF) (56.5% vs 43. 5%, &lt;em&gt;p&lt;/em&gt;=0.79), ACFL points (55 vs 53, &lt;em&gt;p&lt;/em&gt;=0.52), leukocytes, PMN and DHL levels in ascites fluid (&lt;em&gt;p&lt;/em&gt;=0.55, &lt;em&gt;p&lt;/em&gt;=0.45 and &lt;em&gt;p&lt;/em&gt;=0.52), and serum albumin (2.32g/dl vs 2.26gr/dl, &lt;em&gt;p&lt;/em&gt;=0.71). An equal response rate was observed at 28/32 (87.5%) for cefotaxime and 26/29(89.7%) for ceftriaxone with no statistical differences between groups. The recurrence rate was similar with 3 cases for each group with no differences between them. The mortality rate was 14/61(23%); 4/32(12.5%) for cefotaxime and 10/29(34.5%) for ceftriaxone with statistical differences between groups. At 30 days total mortality was 9/61(14.8%) with 2/32(6.2%) for cefotaxime and 7/29 (24.13%) for ceftriaxone with no difference between groups Log-Rank(1) = 3.","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"30 ","pages":"Article 101863"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143896007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of the prognostic nutritional index as a prognostic factor in patients with hepatocellular carcinoma.","authors":"Vilma Hernandez-Garza,&nbsp;Berenice Lorenzo-Valle,&nbsp;Kenia Michel Bastida-Guadarrama,&nbsp;Santiago Camacho-Hernandez,&nbsp;Fátima Higuera-de-la-Tijera","doi":"10.1016/j.aohep.2025.101864","DOIUrl":"10.1016/j.aohep.2025.101864","url":null,"abstract":"<div><h3>Introduction and Objectives</h3><div>Immune-nutritional status has been demonstrated to be associated with prognosis in patients with various malignancies. The aim of this study is to determine the association of the nutritional prognostic index (PNI) with survival and assess the correlation between PNI and clinic-pathological parameters in HCC patients.</div></div><div><h3>Materials and Patients</h3><div>An observational, retrospective, descriptive and case series study was performed. We included 69 patients from a third-level hospital with a diagnosis of HCC from February 01, 2019 to July 24, 2023 and studied their survival 12 months after diagnosis. We determined the association between PNI status and their clinic-pathological characteristics and evaluated the impact of PNI on the HCC patient survival. The following formula was used to determine PNI: 10 × serum albumin (g/dL) + 0.005 × total lymphocyte count (per µL). Clinic-pathological characteristics related to disease prognosis included age, sex, body mass index (BMI), alpha-fetoprotein (AFP) value, the presence or not of cirrhosis, tumor size, ECOG score, and BCLC grade. Qualitative data are expressed as percentages and quantitative data as mean±SD. Statistical comparison was performed with two-tailed unpaired Student's t-test or chi-square and Fisher's exact test. Statistical significance was defined as P&lt;0.05.</div></div><div><h3>Results</h3><div>Of the 69 patients diagnosed with HCC, most of the studied population was found to involve males at 56.52% while females were reported at 43.48%, with an age range of 26-81 years and a median age of 61.84, 61.84±9.8 (59.53-64.15). Of the total sample, 10.14% were patients with no diagnosis of cirrhosis while 89.86% were patients with some degree of cirrhosis (Child Pugh Stages: A 37.68%, B 43.48%, C 8.70%). The results indicated that low PNI is associated with poor prognosis while high PNI was found to be beneficial for survival with a 95 % CI=35.48±8.41 (32.42-38.54), 95% CI=40.86±5.42 (39.19-42.54) p=0.0019, respectively. It is also associated with more favorable outcomes, such as lower AFP, lower ECOG grade and lower BCLC staging (p=0.0371, p=0.0303, p= 0.002), respectively. However, we found that age, sex, presence or absence of cirrhosis, BMI and tumor size were not statistically significantly associated with the PNI value.</div></div><div><h3>Conclusions</h3><div>PNI is an independent predictive indicator of survival and is significantly associated with serum AFP, ECOG score, and BCLC stage in patients with HCC.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"30 ","pages":"Article 101864"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143896008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}